Organization
NORTH WEST BEHAVIORIAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES DAVID TIMMONS B.A. (CASE MANAGER)
(904) 781-7797
Entity
Organization
Contact information
Practice address
2392 EDGEWOOD AVE N, JACKSONVILLE, FL 32254-1725
(904) 781-7797
Mailing address
2392 EDGEWOOD AVE N, JACKSONVILLE, FL 32254-1725
(904) 781-7797
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
12/07/2016
Last updated
12/07/2016
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